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Background: Pneumocystis constitutes a highly diversified biological group, with numerous species, which are strongly host-specific and well adapted to live inside the lungs of a diverse range of mammals. The detection of DNA from Pneumocystis in clinical specimens by PCR assays is leading to important advances in pneumonia caused by Pneumocystis and its epidemiology. The aim of this study was to analyze two different diagnostic methods, real-time PCR (qPCR) using primers based in the Major Surface Glycoprotein (MSG) of Pneumocystis sp. and conventional nested PCR using primers designed to the small subunit of mitochondrial rRNA (mtSSU rRNA) for detection of Pneumocystis DNA in lung tissue from bats. Materials, Methods & Results: Bats (195 samples) were captured (2007-2009) in caves, forests, and urban areas, were obtained from the Program of Rabies Control of two states in Brazil: Mato Grosso and Rio Grande do Sul, located respectively in the Mid-Western and Southern regions of the country approximately 2000 km apart. Lung tissue (250 mg) was finely minced, homogenized with crushing and DNA extraction was carried out with commercial kit. DNA samples the lung tissue of bats were analyzed by nested PCR, using oligonucleotide primers designed for the gene encoding the mitochondrial small subunit r RNA (mtSSU rRNA) and Taqman probe and primers for qPCR were selected based on the Major Surface Glycoprotein (MSG) of Pneumocystis sp. Chi-square (P < 0.001 was considered significant) and the McNemar's test was used to analyze nested PCR and qPCR as methods of detection of Pneumocystis sp. and the Kappa was calculated by Win Episcope 2.0. To assess the sensitivity and specificity of the qPCR assay, a nested PCR assay was considered as the reference method. The positivity was 36.4% in the nested PCR and 24.1% using the qPCR. Concordance was obtained in 68.2% of the samples (133/195). It was demonstrated that there was no statistically significant difference between the techniques used and, both tests proved to be specific for the detection of Pneumocystis species. Specificity was 71% for the nested PCR and 84.6% for the qPCR. Pneumocystis was detected (71/195) by the nested PCR assay in 14 species:. Tadarida brasiliensis, Histiotus velatus, Desmodus rotundus, Molossus molossus, Glossophaga soricina, Nyctinomops laticaudatus, Promops nasutus, Artibeus sp., Eptesocus furinalus, Lasurus blossevillii, Molossus currentium, Molossus rufus, Myotis levis and Nyctinomops macrotis. Discussion: This study detected the DNA from Pneumocystis through the nested PCR and qPCR assays, and the frequency found is comparable to that obtained in a previous study, which used the nested PCR in Central American, South American and European countries. Pneumocystis sp. was observed in a high number of different bat species (14) in two Brazilian States (RS and MT). The qPCR showed a higher specificity in comparison to the nested PCR. The literature has similar findings to the results obtained by this research, employing the same tests and genes. The nested PCR and qPCR assays are indicated in the diagnosis of Pneumocystis sp. in bats and it is important to highlight that a better diagnostic precision is achieved with the association of both tests. Additionally, this study was the first to detect Pneumocystis sp. in the lungs of bats using qPCR. [ABSTRACT FROM AUTHOR]

Online partial discharge (PD) analysis of power transformers is sometimes complex due to the presence of large disturbance and noise as well as to uncertainty in PD source identification. In this paper, a novel approach to PD detection and analysis in online power transformers is presented. The proposed approach provides hardware and software tools to remove disturbance, noise, separate contributions from different sources and, eventually, identify PD sources. Besides, a description of the hardware tools used to assemble the diagnostic system, the tests (in the lab and on real transformers) carried out to build the reference database needed for identification system training will be discussed, providing rules for PD source identification. A number of working cases will be presented to show the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

This paper presents a technique for outdoor ceramic insulator pollution assessment based on partial discharge detection and analysis. Laboratory tests and data coming from a monitoring activity carried out on some insulators of transmission lines are reported. They support the effectiveness of partial discharge detection and analysis as a tool to carry out condition-based maintenance of insulators of overhead lines. In particular, it can be seen that partial discharge analysis highlights the mechanisms bringing insulators to flashover (dry band arc activity) and is, therefore, well suited to predict increasing pollution and imminent flashover. As a consequence, algorithms are proposed to provide a quantitative evaluation of pollution severity. [ABSTRACT FROM AUTHOR]

Development of rapid and multiplexed diagnostic tools is a top priority to address the current epidemic problem of sexually transmitted diseases. Here we introduce a novel nanoplasmonic biosensor for simultaneous detection of the two most common bacterial infections: Chlamydia trachomatis and Neisseria gonorrhoeae . Our plasmonic microarray is composed of gold nanohole sensor arrays that exhibit the extraordinary optical transmission (EOT), providing highly sensitive analysis in a label-free configuration. The integration in a microfluidic system and the precise immobilization of specific antibodies on the individual sensor arrays allow for selective detection and quantification of the bacteria in real-time. We achieved outstanding sensitivities for direct immunoassay of urine samples, with a limit of detection of 300 colony forming units (CFU)/mL for C. trachomatis and 1500 CFU/mL for N. gonorrhoeae . The multiplexing capability of our biosensor was demonstrated by analyzing different urine samples spiked with either C. trachomatis or N. gonorrhoeae , and also containing both bacteria. We could successfully detect, identify and quantify the levels of the two bacteria in a one-step assay, without the need for DNA extraction or amplification techniques. This work opens up new possibilities for the implementation of point-of-care biosensors that enable fast, simple and efficient diagnosis of sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Objective: To establish a standard location for examining penile cavernosal arteries (CAs) using dynamic duplex Doppler ultrasound (PDDU) examination in the diagnosis of non-arterial erectile dysfunction (ED) or arterial insufficiency.Patients and Methods: Two groups of 105 patients each were enrolled. The first group (age 56.3 ± 6.0 years) displayed clinical patterns of arterial insufficiency; the second group (age 35.2 ± 4.7 years) displayed clinical patterns of non-arterial ED. The patients had their peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI = PSV - EDV/PSV × 100), and acceleration time of the CAs measured using PDDU at the crura and at the midpoint between the penoscrotal junction and the coronal sulcus (mid penis). Intra- and interoperator variability were assessed. The PSV, RI, acceleration time, and EDV data obtained from the penoscrotal junction or from the "mid penis" in group 1 and in group 2 were compared using analysis of variance.Results: The PSV, EDV, and acceleration time were significantly higher when measured at the crura penis than when measured at the "mid penis" in both groups, whereas the RI was higher at the "mid penis" than at the "crura." Thus, arterial ED was better diagnosed with the data from the mid penis, whereas non-arterial ED was better diagnosed at the "crura."Conclusion: The location of the sampling site of the CAs using PDDU is critical for a correct diagnosis of ED. [ABSTRACT FROM AUTHOR]

This paper presents a methodology for the diagnosis of HVDC systems based on partial discharge analysis. In particular, the characteristics of partial discharge phenomena from different test objects are highlighted, with the aim of providing tools enabling automatic identification of the type of PD, as well as noise and disturbance rejection, for on-line and/or off-line PD testing of HVDC equipments. The results show that, using a fuzzy identification system based on higher-order moments of the PD magnitude and inter-time distributions, corona phenomena can be identified easily, whereas it is sometimes difficult to distinguish between internal and surface partial discharge sources. For this purpose, the characteristics of internal and surface partial discharge phenomena as a function of influence variables as humidity and temperature are reported. By exploiting these characteristics through on-line/off-line PD monitoring systems, accurate identification of the PD phenomena affecting an electrical apparatus can be attained. [ABSTRACT FROM AUTHOR]

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common familial cerebral small vessel disease, caused by NOTCH3 gene mutations. The aim of our study was to identify clinical and neuroradiological features which would be useful in identifying which patients presenting with lacunar stroke and TIA are likely to have CADASIL.Methods: Patients with lacunar stroke or TIA were included in the present study. For each patient, demographic and clinical data were collected. MRI images were centrally analysed for the presence of lacunar infarcts, microbleeds, temporal lobe involvement, global atrophy and white matter hyperintensities.Results: 128 patients (mean age 56.3 ± 12.4 years) were included. A NOTCH3 mutation was found in 12.5% of them. A family history of stroke, the presence of dementia and external capsule lesions on MRI were the only features significantly associated with the diagnosis of CADASIL. Although thalamic, temporal pole gliosis and severe white matter hyperintensities were less specific for CADASIL diagnosis, the combination of a number of these factors together with familial history for stroke result in a higher positive predictive value and specificity.Conclusions: A careful familial history collection and neuroradiological assessment can identify patients in whom NOTCH3 genetic testing has a higher yield. [ABSTRACT FROM AUTHOR]

Regarding a patient with dyspnea, the history and physical examination often lead to the correct diagnosis. In some circumstances, when more than one underlying disease is present, the diagnostic process can be more challenging. We describe an unusual case of dyspnea and persistent hypoxemia related to a hepatopulmonary syndrome in a 53-year-old patient with known heart failure and chronic liver disease. Initially managed with intravenous diuretic therapy, due to signs of lung and peripheral congestion, our patient did not improve as expected; therefore we performed more advanced studies with a chest-abdomen CT scan and a right heart catheterization. They showed, respectively, no signs of parenchymal and vasculature lung disease, a cirrhotic liver disease, splenomegaly, signs of portal hypertension, and high cardiac output with normal pulmonary vascular resistance. These results, along with the association of hypoxemia and chronic liver disease, suggested a hepatopulmonary syndrome. The diagnosis was confirmed by the demonstration of an intrapulmonary vascular dilatation with right to left shunt during a microbubble transthoracic echocardiography and a lung perfusion scan. Liver transplantation is the only successful treatment for this syndrome; however, the patient became soon unsuitable for this strategy, due to a rapid clinical deterioration. [ABSTRACT FROM AUTHOR]

To assess the clinical utility of targeted Next-Generation Sequencing (NGS) for the diagnosis of Inherited Retinal Dystrophies (IRDs), a total of 109 subjects were enrolled in the study, including 88 IRD affected probands and 21 healthy relatives. Clinical diagnoses included Retinitis Pigmentosa (RP), Leber Congenital Amaurosis (LCA), Stargardt Disease (STGD), Best Macular Dystrophy (BMD), Usher Syndrome (USH), and other IRDs with undefined clinical diagnosis. Participants underwent a complete ophthalmologic examination followed by genetic counseling. A custom AmpliSeq™ panel of 72 IRD-related genes was designed for the analysis and tested using Ion semiconductor Next-Generation Sequencing (NGS). Potential disease-causing mutations were identified in 59.1% of probands, comprising mutations in 16 genes. The highest diagnostic yields were achieved for BMD, LCA, USH, and STGD patients, whereas RP confirmed its high genetic heterogeneity. Causative mutations were identified in 17.6% of probands with undefined diagnosis. Revision of the initial diagnosis was performed for 9.6% of genetically diagnosed patients. This study demonstrates that NGS represents a comprehensive cost-effective approach for IRDs molecular diagnosis. The identification of the genetic alterations underlying the phenotype enabled the clinicians to achieve a more accurate diagnosis. The results emphasize the importance of molecular diagnosis coupled with clinic information to unravel the extensive phenotypic heterogeneity of these diseases. [ABSTRACT FROM AUTHOR]

The article presents a case study of a man who underwent an abdominal ultrasound for general checkup. Topics discussed include ultrasound revealing a hypoechoic lesion at the head of the pancreas, intraoperative histological examination of one retro-pancreatic lymph node made diagnosis of metastasis from neuroendocrine tumor (NET), and minor papilla NETs having a today a facilitated diagnosis due to the growing improvement of diagnostics and endoscopy.

The article presents a case study of a 60-year-old woman who was admitted to a hospital with a violaceousindurated plaque on the infero-external quadrant of the right breast and was diagnosed with angiosarcoma of the breast. The patient has then underwent adjuvant chemotherapy with medications of taxotere, epirubicin and cyclophosphamide. The patient was also given breast reconstruction after her radiochemotherapy.

The aim of this study was to compare a recent multiple allergosorbent chemiluminescent assay (MAST-CLA) with the RAST for the diagnosis of inhalant allergic disease in 232 patients with rhinitis and/or bronchial asthma. As judged by concordance of clinical history, skin prick tests to a range of six allergens common to our geographic area, and by nasal provocation tests, 70 patients were non-allergic and 162 allergic: 70 to grasses, 46 to mites, four to mugwort, eight to peilitory, and 34 were sensitive to several allergens. In our patient sample that, among other things, comprises subjects with fairly rare monoallergies, MAST-CLA testing gave results which closely corresponded to positive RAST for the allergens studied, and demonstrated a close correlation with the diagnosis of inhalant-specific allergy. Our results showed that, for overall allergens, MAST-CLA was lightly less sensitive and more specific than RAST (the two in vitro tests gave an identical overall efficiency). [ABSTRACT FROM AUTHOR]

The article discusses the case of a patient diagnosed with pancreaticopleural fistula (PPF). Topics discussed include the clinical presentation of the patient, pleural effusion revealed by chest radiography, and the result of thoracoabdominal computed tomography (CT). Also highlighted is the treatment of the patient with antimicrobial agents and somatostatin analogs.

The article presents a case study of 27 year old male suffering from multi-fragmentary fracture. Topics discussed include presence of centimetric tumefaction lesion upon physical examination, symptoms of esophagocutaneus fistula (ECF), complications caused to pneumonectomy because of ECF, and mentions majority of ECF symptoms after cervical spine surgery.

The article focuses on a Chronic tension-type headache (CTTH) induce a pain sensation in the trapezium area. The article discusses the CTTH treatment with Quantum Molecular Resonance (QMR) therapy which helps to promote cell regeneration process through direct cell stimulation which is able to decrease local inflammatory reaction and consequently pain level. The article also discusses the prophylactic treatment for CTTH including antidepressants, muscle relaxants, drugs is used by patients.

The article presents a case study of a 43-year-old male diagnosed from empyema thoracis after blunt traumatic esophageal perforation. Topics discussed include several medical conditions revealed by computed tomography (CT), including multiple rib fractures, total left pneumothorax, and bilateral pneumomediastinum, concomitant pleural injury, and keratitis caused by Bacillus species.

The authors discuss the advantages of diagnostic and therapeutic laparoscopy for abdominal impalement injuries (AII). They describe the use of laparoscopic surgery in treating a 13-year-old boy who sustained an AII from a ballpoint point in his pants pocket after jumping over a fence. They also explain the types of impalement injuries and some basic principles for their management.

The article presents a case study of a 27-year-old Caucasian man diagnosed with colonic-type appendiceal adenocarcinoma, a rare tumour of the gastrointestinal tract. The patient underwent several medical procedures including histological examination, appendectomy and second-look operation that consisted of right hemicolectomy with lymphadenectomy. The authors consider the said medical condition as an intermediate prognosis between mucinous and signet ring cell adenocarcinoma.